scholarly journals Effect of Brief Biofeedback via a Smartphone App on Stress Recovery: Randomized Experimental Study

10.2196/15974 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e15974 ◽  
Author(s):  
John F Hunter ◽  
Meryl S Olah ◽  
Allison L Williams ◽  
Acacia C Parks ◽  
Sarah D Pressman

Background Smartphones are often vilified for negatively influencing well-being and contributing to stress. However, these devices may, in fact, be useful in times of stress and, in particular, aid in stress recovery. Mobile apps that deliver evidence-based techniques for stress reduction, such as heart rate variability biofeedback (HRVB) training, hold promise as convenient, accessible, and effective stress-reducing tools. Numerous mobile health apps that may potentially aid in stress recovery are available, but very few have demonstrated that they can influence health-related physiological stress parameters (eg, salivary biomarkers of stress). The ability to recover swiftly from stress and reduce physiological arousal is particularly important for long-term health, and thus, it is imperative that evidence is provided to demonstrate the effectiveness of stress-reducing mobile health apps in this context. Objective The purpose of this research was to investigate the physiological and psychological effects of using a smartphone app for HRVB training following a stressful experience. The efficacy of the gamified Breather component of the Happify mobile health app was examined in an experimental setting. Methods In this study, participants (N=140) underwent a laboratory stressor and were randomly assigned to recover in one of three ways: with no phone present, with a phone present, with the HRBV game. Those in the no phone condition had no access to their phone. Those in the phone present condition had their phone but did not use it. Those in the HRVB game condition used the serious game Breather on the Happify app. Stress recovery was assessed via repeated measures of salivary alpha amylase, cortisol, and self-reported acute stress (on a 1-100 scale). Results Participants in the HRVB game condition had significantly lower levels of salivary alpha amylase during recovery than participants in the other conditions (F2,133=3.78, P=.03). There were no significant differences among the conditions during recovery for salivary cortisol levels or self-reported stress. Conclusions These results show that engaging in a brief HRVB training session on a smartphone reduces levels of salivary alpha amylase following a stressful experience, providing preliminary evidence for the effectiveness of Breather in improving physiological stress recovery. Given the known ties between stress recovery and future well-being, this study provides a possible mechanism by which gamified biofeedback apps may lead to better health.


2019 ◽  
Author(s):  
John F Hunter ◽  
Meryl S Olah ◽  
Allison L Williams ◽  
Acacia C Parks ◽  
Sarah D Pressman

BACKGROUND Smartphones are often vilified for negatively influencing well-being and contributing to stress. However, these devices may, in fact, be useful in times of stress and, in particular, aid in stress recovery. Mobile apps that deliver evidence-based techniques for stress reduction, such as heart rate variability biofeedback (HRVB) training, hold promise as convenient, accessible, and effective stress-reducing tools. Numerous mobile health apps that may potentially aid in stress recovery are available, but very few have demonstrated that they can influence health-related physiological stress parameters (eg, salivary biomarkers of stress). The ability to recover swiftly from stress and reduce physiological arousal is particularly important for long-term health, and thus, it is imperative that evidence is provided to demonstrate the effectiveness of stress-reducing mobile health apps in this context. OBJECTIVE The purpose of this research was to investigate the physiological and psychological effects of using a smartphone app for HRVB training following a stressful experience. The efficacy of the gamified Breather component of the Happify mobile health app was examined in an experimental setting. METHODS In this study, participants (N=140) underwent a laboratory stressor and were randomly assigned to recover in one of three ways: with no phone present, with a phone present, with the HRBV game. Those in the <italic>no phone</italic> condition had no access to their phone. Those in the <italic>phone present</italic> condition had their phone but did not use it. Those in the <italic>HRVB game</italic> condition used the serious game Breather on the Happify app. Stress recovery was assessed via repeated measures of salivary alpha amylase, cortisol, and self-reported acute stress (on a 1-100 scale). RESULTS Participants in the <italic>HRVB game</italic> condition had significantly lower levels of salivary alpha amylase during recovery than participants in the other conditions (F<sub>2,133</sub>=3.78, <italic>P</italic>=.03). There were no significant differences among the conditions during recovery for salivary cortisol levels or self-reported stress. CONCLUSIONS These results show that engaging in a brief HRVB training session on a smartphone reduces levels of salivary alpha amylase following a stressful experience, providing preliminary evidence for the effectiveness of Breather in improving physiological stress recovery. Given the known ties between stress recovery and future well-being, this study provides a possible mechanism by which gamified biofeedback apps may lead to better health.



Author(s):  
Angelina Kouroubali ◽  
Lefteris Koumakis ◽  
Haridimos Kondylakis ◽  
Dimitrios G. Katehakis

This paper analyzes the clinical and technological characteristics of cancer mobile apps that enable patients to securely record, manage, and share their information. It proposes an integrated approach towards developing quality mobile health apps for cancer and discusses issues relevant to the enhancement of patient experience and acceptance, adherence to treatment, and effective support of coordinated care. Regulation, standardization, and interoperability together with the existence of useful, accurate, and reliable tools for active patient engagement are important aids towards efficient cancer disease management. Improving quality of life and well-being, in a secure and safe manner that respects the patients' privacy, seems to be a key challenge, together with the exploitation of the outcomes of recent research projects, relevant to end user digital engagement towards an integrated approach for the introduction of trustworthy, interoperable, usable, adaptable, and quality mobile health apps.





2019 ◽  
Vol 22 ◽  
pp. S317
Author(s):  
X. Feng ◽  
T. Lavelle ◽  
P.J. Lin


10.2196/18513 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e18513
Author(s):  
Alejandro Plaza Roncero ◽  
Gonçalo Marques ◽  
Beatriz Sainz-De-Abajo ◽  
Francisco Martín-Rodríguez ◽  
Carlos del Pozo Vegas ◽  
...  

Background Mobile health apps are used to improve the quality of health care. These apps are changing the current scenario in health care, and their numbers are increasing. Objective We wanted to perform an analysis of the current status of mobile health technologies and apps for medical emergencies. We aimed to synthesize the existing body of knowledge to provide relevant insights for this topic. Moreover, we wanted to identify common threads and gaps to support new challenging, interesting, and relevant research directions. Methods We reviewed the main relevant papers and apps available in the literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used in this review. The search criteria were adopted using systematic methods to select papers and apps. On one hand, a bibliographic review was carried out in different search databases to collect papers related to each application in the health emergency field using defined criteria. On the other hand, a review of mobile apps in two virtual storage platforms (Google Play Store and Apple App Store) was carried out. The Google Play Store and Apple App Store are related to the Android and iOS operating systems, respectively. Results In the literature review, 28 papers in the field of medical emergency were included. These studies were collected and selected according to established criteria. Moreover, we proposed a taxonomy using six groups of applications. In total, 324 mobile apps were found, with 192 identified in the Google Play Store and 132 identified in the Apple App Store. Conclusions We found that all apps in the Google Play Store were free, and 73 apps in the Apple App Store were paid, with the price ranging from US $0.89 to US $5.99. Moreover, 39% (11/28) of the included studies were related to warning systems for emergency services and 21% (6/28) were associated with disaster management apps.



Author(s):  
Asim Zia ◽  
Arthur Brassart ◽  
Sheila Thomas ◽  
Fen Ye ◽  
Judith Stephenson ◽  
...  

Background: Lack of adherence with prescribed medications among the asthma populations exacerbates health outcomes and increases social and economic costs. Objectives: The proposed study aims to model patient-centric structural determinants of adherence rates among asthma patients and explore the potential of mobile health apps such as the TRUSTR platform to improve adherence using its power of monetary and non-monetary chatbotting and non-monetary nudges. Following specific hypotheses are tested: (1) Patient attributes, such as their age and medical condition, have significant effect on their adherence with the prescribed treatment plans. (2) Behavioral nudging with rewards and engagement via mobile health apps will increase adherence rates. Methods: The patient population (N= 37 359) consists of commercially insured patients with asthma who have been identified from administrative claims in the HealthCore Integrated Research Database (HIRD) between April 1, 2018 and March 31, 2019. Two Structural Equation Models (SEMs) are estimated to quantify direct, indirect and total effect sizes of age and medical condition on proportion of days covered (PDC) and medical possession ratio (MPR), mediated by patient medical and pharmacy visits. Fourteen additional SEMs were estimated to lateralize TRUSTR findings and conduct sensitivity analysis. Results: HIRD data reveal mean adherence rate of 59% (standard deviation (SD) 29%) for PDC and 58% for MPR (SD 36%). Key structural findings from SEMs derived from the HIRD dataset indicate that each additional year in the age of the patient has a positive total effect on the adherence rate. Patients with poor medical condition are likely to have lower adherence rate, but this direct effect is countered by mediating variables. Further, each additional reward and higher engagement with a mobile app is likely to have a positive total effect on increasing the adherence rate. Conclusions: HIRD data reveal mean adherence rate of 59% (SD 29%), providing the evidence for the opportunity to increase adherence rate by around 40%. Statistical modeling results reveal structural determinants, such as the opportunity to nudge, are higher among younger patients, as they have higher probability of being non-adherent. Methodologically, lateralization approach demonstrates the potential to capture real-world evidence beyond clinical data and merge it with clinical data.



10.2196/16518 ◽  
2019 ◽  
Author(s):  
Eunsin Joo ◽  
Anastasia Kononova ◽  
Shaheen Kanthawala ◽  
Wei Peng ◽  
Shelia Cotten


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arunima Vijay ◽  
Gloria Wu

Introduction: Hypertension affects 108 million Americans. To help track and manage hypertension, there are many free and popular mobile health apps that track BP. Hypothesis: BP tracking mobile health apps have many downloads but do not fully educate the public about hypertension risk factors. Methods: “Blood Pressure” as a search term was used in the Google Play and Apple iOS stores to identify the most popular, free BP tracking apps aimed at the lay public. The top 10 most popular, free apps on each store were evaluated for educating the lay public on hypertension risk factors. Inclusion criteria: top 10 free blood pressure (BP) apps, by highest number of downloads on Google Play and highest rating (out of five stars) on Apple iOS Store (no available data on iOS downloads). Exclusion criteria: non-English, requiring a wearable device, primary purpose other BP tracking. Results: Of top 20 apps: BP log: 19/20, BP ranges: 13/20, height: 5/20, weight: 8/20, BMI: 3/20, race: 1/20, gender: 4/20, age: 6/20, diet: 1/20, exercise: 1/20, medication: 4/20, diabetes: 1/20, FBS: 1/20, goals: 3/20, mood/depression: 1/20. 2 apps mentioned the American Heart Association (AHA). None of the apps had information on cvriskcalculator.com, family history, cholesterol, LDL, triglycerides, HbA1c, and alcohol use. Conclusion: Most free and popular BP apps monitor BP but largely ignore hypertension risk factors such as cholesterol, LDL, triglycerides, alcohol intake, mood/depression, race, and gender. Furthermore, 7/20 apps do not uniformly educate patients that a normal BP is <120/<80, in accordance with the AHA and ACC guidelines. More collaboration may be needed between physicians and software developers to educate and meet the needs of our hypertensive patients in America.



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